In the balancing of cost vs. coverage for health insurance, the two basic coverage questions are who and what — as in who is covered and what illnesses are covered. The legislature is going to spend much of this session thinking about the who; Wednesday, the Banking and Insurance Committee will focus on the what.

Specifically, advocates for the mentally ill want parity, not just partial coverage, as previous legislation has achieved, with a list of illnesses that include such items as bipolar and eating disorders, schizophrenia, paranoia, autism and panic disorder. And they want the spending ceilings and high co-pays to be brought into line with insurance for physical illnesses. The legislation, LD 1158, would primarily affect small-group and individual insurance; large-group plans are largely already required to cover these illnesses. The bill originally included coverage for adults but has since been scaled back to affect children only.

The argument against adding mental health parity to insurance coverage — that it costs too much — makes an assumption that has yet to be tested. It assumes that all physical ailments currently covered are more deserving of coverage than any mental illness proposed for coverage. But is covering prescription cough medicine more important than covering anorexia? Why is coverage for one illness simply accepted as a right while coverage for another is blamed for adding cost?

The Maine Bureau of Insurance recently reviewed the costs of LD 1158 and concluded that under the old fee-for-service system individual premiums could increase 3.6 percent; small group, 2.6 percent; and large group, .3 percent. Under a comprehensive managed care plan, those costs are reduced by approximately two-thirds. These are relatively small increases for large potential gains. A serious mental illness can devastate a child and cripple a family emotionally and financially. The illnesses listed in the bill are not the problems of the so-called worried well, but are afflictions that can lead to more critical outcomes. Lawmakers might keep in mind that the second-leading cause of death among young Mainers is suicide — some 426 people ages 10 to 24 took their own lives over a recent 14-year period.

The Banking and Insurance Committee will hear a couple of other parity bills — for substance-abuse treatment and long-term disability insurance for mental illness — when it meets at the Augusta Civic Center this week, and the primary opposition to them likely will be cost. It is a fair consideration, and one that even mental-health advocates would not deny. But for bills like LD 1158 the larger question is what Maine residents get for a small increase. It is substantial, and well worth supporting.